From:  The transition from NAFLD to MASLD: implications for Diagnosis, Prognosis, and Clinical Management

 Emerging pharmacological treatments for MASLD: targets, efficacy, and limitations.

Drug classMolecular targetDevelopment stageClinical benefitsLimitations/adverse effectsReferences
GLP-1 RAs (e.g., semaglutide)GLP-1 receptorPhase 3/approvedReduction in steatosis, inflammation, weightGastrointestinal effects, high cost[109, 110]
PPAR agonists (e.g., pioglitazone, lanifibranor)PPAR-γ, pan-PPARPioglitazone approved, lanifibranor under studyImprovement in insulin resistance and fibrosisWeight gain, fluid retention[106, 121]
SGLT2 inhibitors (e.g., empagliflozin)SGLT2Off-labelReduction in liver enzymes and steatosisUrogenital infections[59, 125]
FXR agonists (e.g., obeticholic acid)FXRAdvanced trialsFibrosis improvementPruritus, dyslipidemia[35]
ResmetiromThyroid hormone receptor βApprovedHistological improvement in MASHLong-term data pending[115]
TirzepatideDual GIP/GLP-1 receptor agonistPhase 3MASH resolution, weight and fibrosis reductionLong-term safety under evaluation[103, 112]

FXR: farnesoid X receptor; GIP: glucose-dependent insulinotropic polypeptide; GLP-1 RAs: glucagon-like peptide-1 receptor agonists; MASH: metabolic dysfunction-associated steatohepatitis; PPAR: peroxisome proliferator-activated receptor; SGLT2: sodium-glucose transporter 2.